Version May 2024
| Regimen (depending on susceptibility) | Adult dose |
| Simple cystitis | |
| Preferred oral agents | |
| Amoxicillin | 500 mg orally 3 times daily for 5 days |
| Nitrofurantoin* | 100 mg (monohydrate/macrocrystals [Macrobid]) twice daily for 5 days |
| Fosfomycin | 3 g (single dose) |
| Alternative oral agents | |
| Levofloxacin | 250 mg orally once daily for 3 days |
| Linezolid | 600 mg orally twice daily for 5 days |
| Alternative agents for patients unable to tolerate oral therapy | |
| Ampicillin | 1 g IV every 6 hours for 5 days |
| Vancomycin, daptomycin, or linezolid | Dosing as summarized below |
| Complicated urinary tract infection¶ | |
| Preferred agents | |
| Ampicillin | 2 g IV every 6 hours |
| Alternative agents | |
| Vancomycin | Initial dose 15 mg/kg/dose IV every 12 hours, not to exceed 2 g per dose; subsequent dosing guided by serum trough concentration monitoringΔ |
| Levofloxacin | 750 mg IV or orally once daily |
| Linezolid | 600 mg orally or intravenously twice daily |
| Daptomycin | 8 mg/kg IV every 24 hours |
IV: intravenously.
* Nitrofurantoin should be avoided if the creatinine clearance is <30 mL/minute. Taking the oral suspension with food is preferred. A higher daily dose of nitrofurantoin oral suspension of macrocrystals is suggested in children ≤12 years (relative to adults and children >12 years) due to formulation differences and resultant urinary tract concentrations.
¶ Results of urine culture and susceptibility testing should be used to tailor the regimen, including switching from a parenteral to an oral regimen once symptoms have improved. Appropriate oral agents to complete treatment for complicated enterococcal urinary tract infection include fluoroquinolones (levofloxacin 750 mg orally once daily) for 5 to 7 days, amoxicillin (1 g orally 3 to 4 times daily; some UpToDate contributors prefer to use lower doses) for 10 to 14 days, or linezolid (600 mg orally twice daily for 5 to 7 days).
Δ There are no data on pharmacologic targets for vancomycin dosing in vancomycin-susceptible enterococcal urinary tract infections. Since vancomycin is excreted into the urine, elevated trough levels (>15 mg/L) are likely not needed and may result in nephrotoxicity. A loading dose and/or higher pharmacologic targets may be considered as guided by the overall condition of the patient or a concern for concurrent infection due to another pathogen (eg, methicillin-resistant Staphylococcus aureus).آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
